CMS Penalizes More Than 700 Hospitals for Hospital-Acquired Conditions

More than 700 hospitals will be penalized in fiscal year 2015 as a result of poor scores in CMS’ Hospital-Acquired Condition (HAC) Reduction Program.

The program, part of the Affordable Care Act, uses public reporting and financial incentives to encourage hospitals to reduce HACs—which include blood clots, bed sores, and other complications considered avoidable—and improve patient safety. A hospital’s performance in the program is determined by the HAC score, which ranges from one to 10; the higher a hospital’s score, the worse the hospital performed.

Starting in fiscal year 2015, hospitals that received the highest HAC scores will be penalized through a payment reduction of 1% for all discharges. CMS announced this week that approximately 724 hospitals will have their payments reduced by 1% for hospital discharges occurring on or after October 1, 2014.

CMS scores hospitals in the HAC program on patient safety and healthcare-associated infections.

Some of the hospitals being penalized include Intermountain Medical Center in Utah, the Cleveland Clinic, Brigham and Women’s Hospital in Boston, and NYU Langone Medical Center, reported NPR. In total, the penalties will save CMS roughly $373 million.

However, Kaiser Health News reported that the penalties are falling particularly hard on academic medical centers. Meanwhile, approximately 1400 hospitals are exempt from the penalties either because they provide specialized treatments or they cater to a particular type of patient. Small critical access hospitals are also exempt.

The news of HAC penalties comes shortly after good news about hospital errors. At the beginning of December, a report from HHS found that there were 1.3 million fewer adverse events harming patients in hospitals in 2011, 2012, and 2013. HACs were down 17% from 2010 to 2013, according to the data from the Agency for Healthcare Research and Quality.

According to the report, in 2013 alone almost 35,000 deaths as a result of declining HACs were averted.